Why is dark urine in the morning and what should I do?

Is it worth worrying if a person discovers that he has dark urine in the morning? In most cases, there is no reason to worry: in the morning, urine is always more concentrated, as pigments accumulate during the night. However, there are other causes of darkening of urine in the morning, and sometimes they can still indicate a certain disease in the body.

Epidemiology

Diseases that are accompanied by the appearance of dark urine in the morning, are considered quite common. An unfavorable ecological background, an intense life rate, a disturbance in the balance of work and rest, poor nutrition - all these factors to some extent complicate the work of the body, including the liver, urinary and endocrine system. According to statistics, at least 4% of the population of our country suffers from kidney disease, and more than half of them are female patients (this is primarily due to the fact that women significantly increase the burden on the urinary system during pregnancy).

If you take into account the physiological darkening of urine in the morning in healthy people, then 9 people out of 10 observe this symptom: an increase in the concentration of urinary fluid during night sleep is considered an unconditional version of the norm.

[1], [2], [3], [4], [5],

Causes of the dark urine in the morning

Dark urine in the morning can be the result of physiological (natural) causes, such as:

• consumption on the eve of food, which gives the urine a dark shade (beet, dark meat, beans, rhubarb, etc.), or drinks (coffee, herbal teas);
• taking certain medications that promote hyperpigmentation of the urinary fluid (aloe, multivitamins, hay preparations, chemotherapy, metronidazole, quinine, etc.);
• low fluid intake during the day, as well as dehydration associated with the hot season, intense physical exertion, strict diets, toxicosis (in pregnant women), etc.

If the darkening of urine is stable, not associated with the above conditions and is accompanied by other unpleasant symptoms, then one can suspect the presence of a pathological process:

• pathology of the liver (toxic hepatitis, viral hepatitis, bile duct stones, cirrhosis);
• digestive disorders that entail dehydration (severe diarrhea, multiple vomiting);
• in men - prostatitis, in women - reproductive system diseases;
• diseases of the urinary system (calculous pyelonephritis, cystitis, the presence of cysts, glomerulonephritis);
• blood diseases, anemia;
• tumor processes in the body (in the kidneys, in the prostate, in the liver, etc.);
• infectious diseases accompanied by fever;
• burns, which are accompanied by dehydration;
• heart diseases.

Rarely, dark urine in the morning is a sign of alkaptonuria, a hereditary disorder in which there is increased excretion in the urine of hemogentisinic acid, which gives it a very dark color. Alkaponuria may be accompanied by the formation of kidney stones, diseases of the joints and heart.

[6], [7], [8]

Risk factors

Specialists identify a number of factors, the presence of which increases the risk of pathological darkening of the urinary fluid:

1. Age from 50 years and older.
2. Recently suffered infectious diseases.
3. Unfavorable family history (when immediate relatives have or had problems with kidneys, liver).
4. Intensive exercise, professional intoxication.
5. Drinking a small amount of fluids, strict diets, taking medication.
6. Pregnancy.

[9], [10], [11], [12]

Pathogenesis

A change in the color of the urinary fluid often accompanies impaired renal function. But why exactly does the color change and the urine becomes dark?

In a healthy body, the shade of urine is determined in the range from amber-yellowish to straw. All these shades are light, but darkening of the urine is possible to darker colors. Than it is caused?

The natural darkening of the urinary fluid is associated with a concentrated content of urochrome, a yellow coloring substance. The concentration of this pigment directly affects the appearance of urine, and in most cases it depends on the amount of liquid consumed by man. It is interesting that the characteristics of drinks that people drink, are manifested in the appearance of urine. For example, if you drink only pure water, the urine will be light and golden, and the use of a variety of sodas with dyes makes the urine darker. The same goes for beer, strong tea, compote of rhubarb.

From the food urine can paint beets, chocolate, cocoa, beans, etc.

[13], [14], [15]

Symptoms of the dark urine in the morning

Urgent to see a doctor is necessary in the event that the dark urine in the morning is accompanied by other adverse symptoms:

• painful sensations in the lumbar region or abdomen;
• disturbances of urination (pain, pain during urination, small amount of urine, frequent urges, etc.);
• the appearance of an unpleasant smell of urine;
• increased body temperature;
• attacks of nausea and vomiting.

The first signs of dark urine may be different, depending on the underlying disease. Sometimes urine is dark throughout the day, and not just in the morning. All these nuances are taken into account by the doctor when making the final diagnosis.

If the urine is dark in the morning and the day is light, then in most cases this is quite normal, indicating an increase in the concentration of urine at night. What can I do to improve the situation? Drink more fluids and urinate at the first urge to urinate, including at night.

Dark urine in the morning in women can be associated with diseases of the genital area and even with sexually transmitted diseases. If the causes of darkening of the urine are indeed pathological, then such a symptom is usually accompanied by a change in the smell of the urinary fluid, the appearance of vaginal discharge, unpleasant sensations in the region of the external genitalia.

At the child the dark urine in the mornings often is connected not only with dehydration, but also with the use in food of an unlimited quantity of the aerated drinks, chocolate, sweets. In summer, such a reaction can be associated with prolonged exposure to the sun.

If a child takes or takes antibiotics the day before, diuretics, vitamins, then urine can also change color: in this case, the color of urine is normalized as soon as the treatment with the listed drugs comes to an end.

Dark urine in men in the morning is often associated:

• with inflammation of the urethra;
• with prostatitis (urine analysis will indicate the presence of pus, blood and mucus);
• with scrotal injuries.

These pathological conditions can be accompanied by pain during urination, increased body temperature, unpleasant sensations in the groin and lower abdomen.

Dark yellow urine in pregnant women in the mornings is often a sign of toxicosis. The reasons in this case consist in a lack of fluid in the body (for example, with swelling or frequent vomiting), in increasing the burden on the kidneys and the pressure of the uterus on the liver, in hormonal changes. Sometimes urine becomes dark due to the fact that a woman during pregnancy takes multivitamin preparations.

If the dark urine is not the only suspicious sign, but manifests itself against the background of other symptoms, then a visit to the doctor should be mandatory. This especially applies to children and pregnant women.

Complications and consequences

If the appearance of dark urine in the morning is associated with physiological natural causes, then it does not make sense to talk about any adverse effects on the body: this is a normal symptom characteristic of most healthy people.

If dark urine is one of the symptoms of the disease, then the prognosis depends on what kind of disease it is, and at what stage of development this pathology is located.

Bacterial infection, which could cause dark urine, can get on the ascending path to the kidneys, which can turn into serious violations in their work. With prolonged infection, as well as in violation of metabolic processes in the kidney and bladder, stones can be formed, which in the future are removed only surgically.

Dehydration of the body affects almost all organs and systems:

• the blood circulation slows down, the minute shock volume of blood decreases, the pressure decreases;
• there are disorders from the nervous system, there are convulsions;
• the kidney function worsens, blood is oversaturated with urea, creatinine, uric acid;
• there is a risk of blood clots, venous blockage;
• there are constipation, digestive disorders, intoxication.

Especially dangerous are chronic and neglected diseases associated with the appearance of dark urine: the earlier the doctor will determine the cause of this condition and take measures, the more favorable will be the further prognosis.

[16], [17]

Diagnostics of the dark urine in the morning

For diagnosis in this situation, a single general analysis of urine will not be enough. As a rule, the doctor appoints a number of different examinations:

• urine analysis according to Zimnitskiy (for evaluation of the concentration function of the kidneys);
• blood tests (including biochemical, with the determination of enzymes AST and ALT);
• bacteriological culture of the urinary fluid (to determine the presence of infection).

In addition, other auxiliary diagnostic methods will be needed.

Instrumental diagnosis usually includes:

• Ultrasound of the kidneys, abdominal cavity (in men - ultrasound of the prostate);
• magnetic resonance imaging (in the transverse, frontal, vertical plane), computed tomography, radiography;
• radioisotope scanning of the liver (allows to identify malignant tumors and cirrhosis of the liver).

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Differential diagnosis

Differential diagnosis with dark urine is carried out:

• with liver diseases (hepatitis, cirrhosis, calculous cholecystitis);
• with pathologies of the urinary tract (pyelonephritis, malignant formations, cysts, kidney stones);
• with prostatic diseases in men and the reproductive sphere in women;
• with violations of hemodynamics;
• with hereditary diseases (alkaponuria);
• with disturbances in metabolic processes.

Treatment of the dark urine in the morning

Since there are many reasons that can lead to dark urine, there are also many methods to eliminate this problem. For example, if the dark urine is the result of a disturbance in the water balance, then you can correct the situation yourself by increasing the amount of liquid consumed per day. Even with consumption of 1500 ml of pure water daily, the urine will become significantly lighter.

If dark urine appears not only in the mornings, but also during the day, it is necessary to consult with a nephrologist or a general practitioner (therapist). After passing the necessary tests, the doctor will prescribe a treatment according to the detected disease.

If the doctor diagnoses hepatitis, the mandatory treatment items will be a diet, the use of hepatoprotective drugs, as well as detoxification therapy (setting up droppers with saline or glucose solution).

When kidney disease is most often used antibiotic therapy (to relieve inflammation) and diuretics (to eliminate swelling and stabilize the pressure).

Drugs for treating dark urine in the morning

	Dosing and Administration	Side effects	Special instructions
Essentiale	Capsules are used for violations of the liver, toxicosis, psoriasis for 2 pcs. Thrice a day with food.	Sometimes - a feeling of discomfort in the abdomen, an allergy.	Essentiale is not used to treat children under 12 years old.
Trental	Tablets are used for circulatory disorders and organ function, 2-4 pcs. Each. Up to 3 times a day.	Possible digestive disorders, redness of the face, frequent palpitations, hypotension, headache, allergies.	Trental is used with caution in patients under 18 years of age.
Prostatilen	Applied with bacterial prostatitis in men, 1 suppository per night, for ten days.	Rarely can there be an allergy to the drug.	For the treatment of women, the drug is not used.
Artichol	Assign for hepatitis, cirrhosis, cholecystitis, nephritis, dyskinesia, 200-400 g three times a day for 15-30 minutes before meals.	Rarely - diarrhea, nausea, allergies.	Artichol is usually well perceived by the body and can be used to treat children from 6 years of age.

Vitamins

To strengthen the body, ensure the normal functioning of the urinary system, the liver and the course of metabolic processes, it is important to use vitamins - either with food, or with special vitamin supplements. When dark urine appears, special attention should be given to such vitamins:

• vitamin A provides protective reactions of the body;
• Vitamin E prevents cell deterioration and strengthens immunity;
• vitamin B ₂  promotes the flow of all biochemical processes;
• ascorbic acid protects the body from all unfavorable influences of the environment;
• lipoic acid stabilizes the metabolism in the body.

In the event that such a symptom as dark urine is found, you need to maximize your diet. It is useful to use a sufficient amount of plant foods, as well as honey, cereals, bran. At least for a while you should give up coffee and tea, replacing them with herbal teas, compotes, fruit drinks, etc.

Physiotherapeutic treatment

Physiotherapy can awaken hidden reserves of the body, strengthen immune protection, shorten the duration of treatment, stimulate the flow of important biochemical processes, adjusting the body to recovery. This is a great way not only to treat, but also to prevent various diseases.

• Inductothermy is the application of a high-frequency alternating magnetic field. It is one of the options for electrotherapy.
• UHF-therapy is the use of the influence on the body of ultrahigh-frequency electromagnetic fields.
• Magnetotherapy - provides for the effect of an alternating magnetic low-frequency field on the whole organism or its individual site.
• Phonophoresis is the method of ultrasound exposure to parts of the body treated with medicinal substances. Phonophoresis is especially often used in urology and gynecology.

Often, for general strengthening of the body, massage, reflexotherapy, manual therapy are used - these methods work not only on the physical, but also on the psychological level, stimulating the acceleration of recovery of the body.

Alternative treatment

To maintain the health of the body and normalize the composition of urine, alternative healers are advised to include in the diet such products:

• Pumpkin and juice from it contains a large amount of vitamins A, C, E. Pumpkin neutralizes the effect of harmful substances, it helps to normalize metabolic processes. Pumpkin flesh can be eaten by everyone, even children and pregnant women - this is one of the least allergenic foods.
• Sea kale is rich not only in iodine, but also in zinc, ascorbic acid, selenium. Regular consumption of sea cabbage will benefit the liver, kidneys, thyroid gland, as well as reduce the risk of cancer. It is ideal to add algae to the dishes every other day.
• Milk, kefir, cottage cheese contain enough calcium, microelements, amino acids. If there is no intolerance to lactose, then these foods should be consumed daily.

In addition, it is recommended to include in the diet more dishes from onions and carrots - these products are considered ideal for the normalization of digestion, facilitating the work of baking to strengthen immune protection.

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Herbal Treatment

Alternative healers offer a wealth of tools to improve the quality of urine:

• infusion or compote of red grapes, twice a day for one cup;
• decoction from the rhizome of the field stalk, three times a day for 30 minutes before breakfast, lunch and dinner;
• infusion from the motherwort, buckthorn bark, marsh swine, field horsetail 100 ml daily three times a day after meals;
• an infusion of an immortelle plant, with an equal number of birch buds, chamomile and St. John's wort 30 minutes before the first meal, and overnight;
• infusion of string, rhizome of burdock, violet leaves, currant, strawberry, yarrow - twice a day after meals;
• decoction of walnut leaves - three times a day before meals.

In addition, it is useful to drink tea from the dog rose, during the day, instead of tea - not less than 1 liter daily.

Black tea is recommended to replace with green, and coffee - a drink from chicory, which less affects the change in the color of urine.

Homeopathy

Homeopathy involves the use of a large number of drugs that can help if there is dark urine in the morning. For example, a remedy such as Calcium is prescribed only with the calcium constitution, with the broken metabolism of potassium, magnesium or urates (with the formation of stones in the gallbladder).

If the dark urine is a consequence of a violation of iron metabolism in the body, then the homeopathic remedy Natrium muriatikum is shown.

The excess amount of salts in the urine is corrected by such drugs:

• at phosphates - Acidum phosphoricum or Calcium phosphoricum;
• with oxalates - Acidum oxalicum and Calcium oxalicum.

In case of impaired renal function, Lycopodium, Berberis, may be prescribed.

Dosages of these drugs are established depending on the initial disease, because of which dark urine appears. All homeopathic remedies have practically no contraindications - only in rare cases such remedies are canceled, with the development of an allergic reaction.

Surgery

Operative intervention is prescribed only in extreme and severe cases of diseases, because of which dark urine appears in the mornings. For example, urgent surgical treatment is indicated in the purulent flow of pyelonephritis. With this diagnosis, the kidneys are decapsulated with the dissection and unfolding of the fibrous capsule, and nephrostomy (installation of drainage into the renal pelvis).

The operation can be shown also in carbuncles and kidney abscesses, with stones in the kidneys or gall bladder, with liver abscess, malignant tumors.

Talking about the surgical intervention with dark urine before the final diagnosis is meaningless, because the disease may well succumb to conservative treatment. And only in neglected cases, the operation can be prescribed - however, in such patients the clinical picture, as a rule, is not limited only to darkening of the urine in the mornings.

Prevention

In order not to face such a sign as dark urine in the morning, it is enough to listen to several preventive tips. They will not only help prevent disease, but also contribute to overall well-being:

1. Take it seriously: give up harmfulness, eliminate spicy, fatty foods, limit salt.
2. If there are no contraindications, drink at least one and a half or two liters of water daily.
3. Black tea and coffee replace with other drinks - for example, compote or freshly squeezed juice.
4. Remember that movement is life. Walk, do gymnastics, play mobile games, swim - it will go to the body only for good.

For any signs of illness, visit the doctor - do not wait for the disease to show itself "at full". It's even better if you get into the habit of undergoing a yearly prophylactic examination of the entire body, with the delivery of common blood and urine tests. Only in this case you will be completely sure that everything is in order with your body.

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Forecast

Dark urine in the mornings most often does not pose a danger to the body, therefore the prognosis can be considered favorable in most cases: it is important only to establish a drinking regime and not to allow fluid deficiency. If any disease is found, the prognosis depends entirely on the diagnosis, the presence of complications, the quality of the treatment, the general condition of the patient, and many other factors.

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